摘要
主动脉夹层首发症状多样,误诊、漏诊率高,及时诊断对预后至关重要。本文对主动脉夹层诊断的时间进行归纳,并从人口统计学因素、既往史、临床表现或体征、相关检查方面对主动脉夹层诊断延迟的影响因素进行综述,得出性别、地理差异、转诊、入院方式、既往史(心脏手术史、主动脉夹层史)、临床表现或体征﹝典型临床表现或体征、非典型表现或体征(无痛、腹痛、胸腔积液、呼吸困难等)﹞、相关检查(心肌肌钙蛋白阳性、心电图异常、胸部X线检查未见纵隔增宽、诊断性检查的数量)为主要影响因素。对临床医生快速识别主动脉夹层提供理论依据,同时,在临床护理工作中对主动脉夹层的初次分诊及留观期间的病情观察具有重要的现实意义。
The initial symptoms of aortic dissection are diverse,and the rate of misdiagnosis and missed diagnosis is high.Moreover,timely diagnosis is crucial for prognosis of aortic dissection.The article summarizes the time of diagnosis of aortic dissection,and summarizes the factors affecting the delayed diagnosis of aortic dissection from demographic factors,past medical history,clinical features or signs,and related examinations,show that gender,geographical difference,referral,admission mode,previous history(history of cardiac surgery,history of aortic dissection),clinical manifestations or signs(typical clinical manifestations or signs,atypical manifestations or signs(no pain,abdominal pain,pleural effusion,dyspnea,etc.),relevant examination(positive cardiac troponin,abnormal ECG,no mediastinal widening in chest X-ray examination,diagnostic examination number of inspections)are the main influencing factor,in order to provide a theoretical basis for clinicians to quickly identify aortic dissection.At the same time,in the clinical nursing work,it is important to the initial triage of the aortic dissection and the observation of the condition during the observation period.
作者
肖亚茹
黄素芳
严丽
李咪琪
周荃
XIAO Yaru;HUANG Sufang;YAN Li;LI Miqi;ZHOU Quan(Department of Emergency,Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430030,China)
出处
《中国全科医学》
CAS
北大核心
2020年第20期2486-2492,共7页
Chinese General Practice
基金
国家自然科学基金资助项目(71874063)。
关键词
主动脉疾病
主动脉夹层
延迟诊断
综述
Aortic diseases
Aortic dissection
Delayed diagnosis
Review
